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    <h1 style="margin:0pt; orphans:0; page-break-after:avoid; page-break-inside:avoid; text-align:center; widows:0"><a
        name="_Toc443467138"></a><a name="_Toc269"><span
        style="font-family:方正小标宋简体; font-size:22pt; font-weight:bold">实</span><span
        style="font-family:方正小标宋简体; font-size:22pt; font-weight:bold">施行政强制措施现场笔录</span><span
        style="-aw-bookmark-end:_Toc443467138"></span></a></h1>
    <p style="margin:0pt; orphans:0; text-align:center; widows:0"><span
            style="font-family:宋体; font-size:18pt; font-weight:bold">&#xa0;</span></p>
    <p style="margin:0pt; orphans:0; text-align:justify; widows:0"><span
            style="font-family:宋体; font-size:12pt">案由：</span><span
            style="font-family:仿宋_GB2312; font-size:12pt; font-weight:bold; text-decoration:underline">                                      </span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt">实施地点：</span><span
            style="font-family:宋体; font-size:12pt; text-decoration:underline">                                  </span><span
            style="font-family:宋体; font-size:12pt">                  </span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt; font-weight:normal">实施时间</span><span
            style="font-family:宋体; font-size:12pt; font-weight:normal"> </span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">                                   </span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt; font-weight:normal">当 事 人：</span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">                                  </span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">地址：</span><span
            style="font-family:仿宋_GB2312; font-size:12pt; font-weight:bold; text-decoration:underline">                   </span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt">法定代表人</span><span
            style="font-family:宋体; font-size:12pt">：</span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">             </span><span
            style="font-family:宋体; font-size:12pt">         </span><span
            style="font-family:宋体; font-size:12pt">职务：</span><span style="font-family:宋体; font-size:12pt"> </span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">          </span><span
            style="font-family:宋体; font-size:12pt">    </span><span
            style="font-family:宋体; font-size:12pt">电话：</span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">          </span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt">执法人员：</span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">               </span><span
            style="font-family:宋体; font-size:12pt">     执法证编号： </span><span
            style="font-family:宋体; font-size:12pt; text-decoration:underline">                   </span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt">执法人员：</span><span
            style="font-family:宋体; font-size:12pt; font-weight:bold; text-decoration:underline">               </span><span
            style="font-family:宋体; font-size:12pt">     执法证编号： </span><span
            style="font-family:宋体; font-size:12pt; text-decoration:underline">                   </span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">&#xa0;</span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt">记录人：</span><span
            style="font-family:宋体; font-size:12pt; text-decoration:underline">                  </span><span
            style="font-family:宋体; font-size:12pt"> </span><span style="font-family:宋体; font-size:12pt">　</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:21pt"><span
            style="font-family:宋体; font-size:12pt">一、实施行政强制</span><span style="font-family:宋体; font-size:12pt">执行</span><span
            style="font-family:宋体; font-size:12pt">的过程和结果</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">　　</span><span
            style="font-family:宋体; font-size:12pt">      </span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">&#xa0;</span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">&#xa0;</span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:24pt"><span
            style="font-family:宋体; font-size:12pt">二、</span><span style="font-family:宋体; font-size:12pt">听取</span><span
            style="font-family:宋体; font-size:12pt">当事人的陈述和申辩</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:24pt"><span
            style="font-family:宋体; font-size:12pt">&#xa0;</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:24pt"><span
            style="font-family:宋体; font-size:12pt">&#xa0;</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:24pt"><span
            style="font-family:宋体; font-size:12pt">三、其他相关情况</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:24pt"><span
            style="font-family:宋体; font-size:12pt">&#xa0;</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt; text-indent:24pt"><span
            style="font-family:宋体; font-size:12pt">&#xa0;</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">当事人（签名）：</span><span
            style="font-family:宋体; font-size:12pt">          </span><span
            style="font-family:宋体; font-size:12pt">年</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">月</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">日</span><span style="font-family:宋体; font-size:12pt">（拒绝签字的，注明：             ）</span>
    </p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">见证人（签名）：</span><span
            style="font-family:宋体; font-size:12pt">          </span><span
            style="font-family:宋体; font-size:12pt">年</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">月</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">日</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span
            style="font-family:宋体; font-size:12pt">执法人员（签名）：</span><span
            style="font-family:宋体; font-size:12pt">        </span><span
            style="font-family:宋体; font-size:12pt">年</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">月</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">日</span></p>
    <p style="font-size:12pt; line-height:150%; margin:0pt"><span style="font-family:宋体; font-size:12pt">记录人（签名）：</span><span
            style="font-family:宋体; font-size:12pt">          </span><span
            style="font-family:宋体; font-size:12pt">年</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">月</span><span style="font-family:宋体; font-size:12pt">  </span><span
            style="font-family:宋体; font-size:12pt">日</span><span
            style="font-family:宋体; font-size:12pt; text-decoration:underline">                </span></p>
    <p style="font-size:14pt; line-height:150%; margin:0pt; orphans:0; text-align:center; widows:0"><span
            style="font-family:宋体; font-size:14pt">&#xa0;</span></p>
    <p style="margin:0pt; orphans:0; text-align:justify; widows:0"><span style="font-family:Calibri; font-size:10.5pt">&#xa0;</span>
    </p></div>
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